MR imaging features of foot involvement in patients with psoriasis
Introduction
Psoriasis is a common, chronic, persistent, inflammatory skin disorder that can have major effect on quality of life. The relationship between psoriasis and inflammatory arthritis has been well recognized since the 19th century and named as psoriatic arthritis (PsA) [1]. Foot involvement in PsA is common and often develops early in the disease [2]. Detailed imaging of foot and ankle can be problematic, because of the complex three-dimensional anatomy. Magnetic resonance (MR) imaging allows direct, noninvasive depiction of tendon, bone and soft-tissue structures of the foot and ankle by its superior soft-tissue contrast resolution and multiplanar capability [3]. The features of foot involvement in PsA using conventional radiography have been reported [4]. To the best of our knowledge, foot involvement assessed by MR imaging in patients with psoriasis has not been reported. The aim of this prospective study was to determine the features of foot involvement using MR imaging in patients with psoriasis.
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Materials and methods
This study was a prospective trial with a standardized protocol. Twenty-six consecutive psoriasis patients (14 female, 12 male; aged 19–64 years; mean 44.2 ± 13.6) were enrolled. They had no arthritic signs or symptoms either in the foot or other joints and were all negative for serum rheumatoid factor. The mean duration of the disease in the study population was 1–37 years with a mean of 23 ± 9.5 years. As a control group; 10 (6 female, 4 male; aged 20–63 years; mean 42.9 ± .12.9) asymptomatic
Results
In the control cases no abnormalities were found. However, changes were found in 24 (92%) of 26 psoriasis patients. In 3 out of 26 patients, the duration of disease was 1 year and all of them showed changes on MR. In the 24 patients with abnormalities in MR, asymmetric, bilateral changes were seen in 16 (67%), and bilateral symmetric changes were noted in 8 (33%). The remaining two patients with psoriasis had no imaging findings. The imaging findings in patients with psoriasis are summarized in
Discussion
Foot and ankle are commonly involved by inflammatory joint disease [11]. Clinical and radiological changes in the foot should be evaluated with care, as they provide valuable diagnostic and prognostic information to guide treatment in patients with inflammatory arthritis [1], [11]. It has been well recognized that MR imaging is more sensitive than clinical examination in the detection of inflammatory changes such as synovitis, tenosynovitis, and enthesopathy and also bone erosions earlier than
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